Emotional Responsiveness in Borderline Personality Disorder The Role of Basal Hyperarousal and Self-Reported Emotional RegulationBortolla, Roberta, PhD*; Roder, Emanuela†; Ramella, Pietro*; Fossati, Andrea*; Maffei, Cesare*†The Journal of Nervous and Mental Disease: March 2019 - Volume 207 - Issue 3 - p 175–183 doi: 10.1097/NMD.0000000000000939 Original Articles Buy Abstract Author InformationAuthors Article MetricsMetrics The present study aims to test the hypothesis of biological hyperarousal and hyperreactivity underpinning the dysfunctional emotional processes of borderline personality disorder (BPD). Self-reported (quality and intensity of emotions) and physiological (respiratory sinus arrhythmia [RSA] and heart rate) data were collected in 14 clinical subjects with BPD and in 14 control subjects (healthy controls [HCs]), during the administration of six video clips with different emotional contents. Our findings showed a constant hyperarousal state (lower RSA) in the clinical group, supporting the hypothesis of a biological vulnerability to emotional dysregulation. BPD patients showed lower self-reported happiness in positive stimuli compared with HCs and a significant association between emotional dysregulation and physiological hyperreactivity to neutral stimuli. Our data support the hypothesis of a constant condition of physiological preparedness to threat and danger in BPD subjects. Moreover, our results highlight the influence of self-reported ability in regulating emotions in explaining BPD responses to specific emotional situations. *Vita-Salute San Raffaele University; and †San Raffaele Hospital, Milan, Italy. Send reprint requests to Cesare Maffei, Clinical Psychology and Psychotherapy Unit, IRCCS San Raffaele-Turro, via Stamira d'Ancona, 20, 20127, Milan, Italy. E-mail: firstname.lastname@example.org. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.